Executive Dysfunction

Executive function is a set of skills that enable you to do things such as:

pay attention

remember information

multitask

The skills are used in:

planning

organization

strategizing

paying attention to little details

time management

These skills start developing around 2 years old and are fully formed by the age of 30.

Executive dysfunction can describe difficulties in any of these abilities or behaviors. It can be a symptom of another condition or result from an event such as a traumatic brain injury.

Sometimes executive dysfunction is called executive function disorder (EFD). EFD is not clinically recognized in the Diagnostic and Statistical Manual of Mental Disorders (DSM) used by mental health clinicians.

Examples of executive function

Executive functions (EFs) are a group of mental processes. It is generally accepted that there are three core executive functions:

inhibition, which includes self-control and selective attention

working memory

cognitive flexibility

These make up the roots from which the other functions stem. Other executive functions include:

reasoning

problem-solving

planning

These functions are necessary for healthy development. They’re especially important in your job or school performance.

A traumatic brain injury can cause executive dysfunction, especially if there has been injury to your frontal lobes. Your frontal lobes are associated with behavior and learning, as well as higher-order thinking processes like planning and organization.

There is also some evidence that executive function can be hereditary.

There are no specific diagnostic criteria for executive dysfunction, since it’s not a specific condition listed in the DSM. Rather, executive dysfunction is a common aspect in the disorders mentioned earlier.

If you suspect that you have executive dysfunction, talk with your doctor. They will examine you to see if any physical condition might be causing your symptoms. They might also refer you to a neurologist, psychologist, or audiologist for further testing.

There’s no single test that identifies executive dysfunction. But there are a variety of screening tools and methods like interviews to discern whether you have any executive dysfunction, and whether it is associated with an existing condition.

If you’re concerned about your child’s executive function, you and their teachers can fill out the Behavior Rating Inventory of Executive Function. This will provide more information about behaviors.

Treating executive dysfunction is an ongoing process and is often lifelong. Treatment can depend on the conditions and the specific types of executive dysfunctions that are present. It can vary over time and depends on the specific EFs that are challenging.

For children, treatment typically includes working with various kinds of therapists, including:

speech therapists

tutors

psychologists

occupational therapists

Cognitive-behavioral therapy and medication can be helpful for individuals with executive dysfunction. Treatments that focus on developing strategies to address the particular dysfunction are also helpful. This could include using:

sticky notes

organizational apps

timers

Medications have been helpful in some individuals with EF disorders. According to one review, the parts of your brain that play roles in EFs use dopamine as the main neurotransmitter. So, dopamine agonists and antagonists have been effective.

Executive dysfunction can interfere with life, school, and work if not treated. Once it's identified, there are various treatments and strategies that can be used to help improve EFs. This will also improve work and school performance and improve your or your child’s quality of life.

Issues with executive function are treatable. If you think you or your child might have EF problems, don’t hesitate to talk with your doctor.